The GenOMICC Study

Genetics Of Mortality In Critical Care

GenOMICC is a, open, collaborative, global community of doctors and scientists trying to understand and treat critical illness. Our partners have been recruiting patients since 2016 to study emerging infections (SARS/MERS/Flu), sepsis, and other forms of critical illness. It is the largest study of its kind anywhere in the world.

COVID-19 is a key aim of GenOMICC

Susceptibility to COVID-19 is almost certainly, in part, genetic. GenOMICC can find the genes that cause susceptibility, which may help us to prioritise treatments to respond to the global crisis. GenOMICC was designed for this crisis. Since 2016, the open, global GenOMICC collaboration has been recruit patients with emerging infections, including COVID-19. All patients with confirmed COVID-19 in critical care are eligible for GenOMICC; please recruit them as normal, following local infection control precautions.

In particular, we aim to recruit every intubated patient with COVID-19. If you need to prioritise, please start with the youngest.

Our genes (or DNA) determine how vulnerable we are to sepsis and other forms of critical illness. We aim to discover specific genes that control the processes that lead to life-threatening illness. If we understand these processes, we think we'll be able to design effective treatments.

To do this we need to get a single DNA sample from lots of criticaly-ill patients with a range of carefully-selected conditions (
see the entry criteria here). The more patients, the better.

Distributed, open-source critical care research

GenOMICC is an open-source research study that aims to engage and unite clinicians and scientists form all over the world to understand the genetic factors that change outcome in critical illness. Achieving this will require cooperation at a grand scale for a prolonged period. By sharing the "source" documents of the study, without restriction, we hope to foster a collegiate spirit that will ultimately enable important progress in critical care medicine worldwide.

Genetic effects will differ among the many different causes of sepsis, and different ethnic groups. This requires global collaboration among critical care doctors, sharing of data between researchers, and an innovative approach to funding.

Establishing GenOMICC in your region

If you want to get involved in GenOMICC, we would suggest the following options:

we will be delighted to collaborate; or

we can help you set up your own study using our protocol, documentation and REDCap data collection tools as a starting point; or,

you can copy and adapt the various study documents available on this website to run your own independent GenOMICC study.

We will support investigators in new regions to establish and lead local research studies using the tools that we have created. Ultimately our motivation is to use GenOMICC to lay the foundations of effective global collaboration in critical care research, with local leadership of the research programme.

Funding

Death from critical illness is strongly affected by genetics

Susceptibility to infection, including sepsis and influenza is known very strongly genetically determined. There are strong reasons to believe the same is true for COVID-19.

In critical illness, a complex cascade of immune signals leads to failure of critical organ systems and death. These events are often not specific to a particular type of infection - they can happen to any patient with a severe infection. Although we know that susceptibility to a particular bug, such as the influenza virus, SARS-CoV-2 (the coronavirus that causes COVID-19), or a bacteria like Staphylococcus aureus, is genetic, it is harder to tell if there are specific genes that alter a patient's chance of survival once they are already desperately sick with sepsis. But we do know that the immune system plays a key role in causing organ failure in sepsis, and in other forms of critical illness. Genetic differences have a very strong impact on immune function.

How to look for answers

There are millions of DNA sequence differences between any pair of humans. Any of these could be important in determining the outcome in sepsis. Finding the ones that matter requires us to look at DNA from huge numbers of patients. We need to look at DNA from thousands of people in order to find robust genetic associations with outcomes. This is urgent, because if we can achieve it then we may be able to find treatments that will ultimately save lives.